Available online 17 September 2022

Most fragility fracture patients are not evaluated or treated for osteoporosis

According to the current study, only 26% of fragility fracture patients received osteoporosis treatment and only 23% had bone density testing

Previous osteoporosis treatment, bone densitometry and endocrinology visit were the most significant factors associated with osteoporosis treatment

Most post-osteoporotic fracture patients do not receive osteoporosis treatment, although it reduces risks for additional fractures. This study reviewed osteoporosis evaluation and treatment following typical osteoporotic fractures in a medical center without an active Fracture Liaison Service.

We identified all patients with hip, vertebral, humerus or radius fractures, examined in Meir Medical Center, in 2017. Exclusion criteria were not a Clalit Health Services member, high energy fracture or 30-day post-operative mortality. Primary endpoint was osteoporosis drugs issued within 12-months of fracture. Secondary endpoints included bone densitometry and 1-year mortality.

Among 928 patients, 346 (37%) were excluded and 582 (78.6±11.1 years-of-age, 75.8% women) were included. Fractures included 321 (55.5%) hip, 84 (14.1%) humerus, 33 (5.6%) vertebra, and 144 (24.7%) radius. Osteoporosis drugs were issued to 26.5%; humerus fracture patients received the least (21.4%) and vertebral the most (30.3%; p=0.51). Age, sex or previous fracture did not affect treatment rates. Bone densitometry was performed in 23.2%; vertebral (39.4%) and radius (34%) fractures most frequently. One-year mortality post-hip fracture was 12.1%, followed by humerus (3.6%), vertebral (3%) and radius (1.4%) (p<0.05). Logistic regression showed previous treatment (OR=7.4, 95%CI 3.6-15.2), bone densitometry (OR=4.4, 95%CI 2.6-7.4) and endocrinology visit (OR=2.6, 95%CI=1.4-4.6) were the most significant discriminating factors associated with osteoporosis treatment.

Fewer than one-third of patients received pharmacotherapy within one-year post-fracture. Since pharmacotherapy reduces future fractures and mortality, we call upon medical staff who care for fracture patients to adopt practical, effective strategies to increase treatment rates among osteoporotic fracture patients.

osteoporosis

osteoporotic fractures

secondary fracture prevention

hip fracture

© 2022 Published by Elsevier Inc. on behalf of the AACE.